Case Presentation. 40 yo woman with no significant PMH presented with LUQ abdominal pain, 50 lb weight loss, and night sweats. On physical exam, she was found to have massive splenomegaly and peripheral lymphadenopathy. CT? adenopathy in axilla (2-3 cm), RP (7.5 x 5 cm), and inguinal (2-3 cm); spleen 22 cm.Inguinal LN biopsy? grade I follicular NHLBone marrow biopsy? 70% cellularity with 30-50% involvement with follicular NHLFLIPI score 4 (Hgb 11.6, LDH 356, Stage IV, > 4 nodal areas)5 yr9441
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